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By Market Intelligence Team

The Challenge of Collaboration is to Do What We Do Not Want to Do

I frequently speak with executives struggling with all this talk about collaboration. From grant funding that goes to community collaboration efforts, to new models in care delivery (i.e. the medical home or community corrections reentry funding)—everything is about collaborating with others. A recent comment I heard at a national conference of behavioral health care executives says it all: “Collaboration is when two consenting adults agree to do what they do not want to do.”

Why is it that we don’t want to do that which we know is in the interest of the consumers we serve and that which will most likely improve the outcome we see? It takes time! And time is money.

According to a study published in the February 17 Annals of Internal Medicine, a typical primary care physician treating elderly Medicare patients must coordinate care with 229 other physicians working in 117 different practices. As Medicare and private health plans experiment with extra payments to primary care physicians to coordinate care, the study findings suggest that substantial delivery system reforms may be needed to make such models work. Experimentation with reimbursement for the time it takes to coordinate care for the chronic patient is the key to the future of collaboration. Inherent in this discussion is whose time, what investment in technology will reduce the time it takes to coordinate care, and who is really in this with me if I choose to make the ‘consenting adult’ decision to do what I ‘do not want to do’?

President Obama’s January 3 radio address put HIT adoption front-and-center as part of a plan to lower health care costs and increase medical safety. The Stimulus package includes $44,000 in incentives for qualifying Medicare providers, and $63,750 to qualifying Medicaid providers for certified EHR adoption. The law provides more than $30 billion in EHR adoption incentives through the Centers for Medicare & Medicaid Services (CMS). Additionally, CMS medical home models promise reimbursement for care coordination.

Now is the time to be honest with ourselves. Is it just the bottom line that is preventing us from collaborating with others? It is our basic instinct to protect our territory. But, like the time of the caveman (or woman) that protected his (or her) hearth, it is time for us to move into the globalization of health care. And yes, it means becoming ‘consenting adults.’ We are a global community with a multitude of opportunities for strategic alliances and synergy. People and organizations across the globe are willing to help support those efforts we know will lead to the outcomes we have been dreaming of for years. So, make your pledge—become a ‘consenting adult’ and open yourself (and your organization) to the idea of collaboration.


Dee Brown, M.S.M.

Senior Associate, OPEN MINDS

Members of the OPEN MINDS Circle may wish to access “Can Data Exchange Between Courts and Child Welfare Agencies Improve Outcomes for Children?,” by Victor Eugene Flango, Executive Director of Program Resource Development, National Center for State Courts. Here Mr. Flango discusses improving outcomes for children via collaboration between courts and child welfare agencies, and how electronic data exchanges can support such collaborations.

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OPEN MINDS Premium Circle members may wish to access “Meeting EHR Needs Through Collaboration: The Peachstate Information Network Case Study,” by Maureen Burke, M.S.Ed., Senior Consultant, OPEN MINDS. Here Ms. Burke discusses the Peachstate Information Network’s (PIN) successful provider technology collaboration.

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